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Biomedical subjects

B Fellmeth

Publications and source records attributed to B Fellmeth.

6 recordsLinked to original sources
PubMed1990

Traumatically-induced embolus to the hand from a thrombosed PTFE vascular access graft.

We report a case of a traumatically-induced embolus from a thrombosed PTFE vascular access graft in a patient who had undergone a successful cadaveric renal transplant. Although usually thought to be without subsequent sequelae, thrombosed PTFE grafts can be a source of emboli to the hand in active young patients. Diagnosis, etiology, and management are discussed. Therapeutic intervention includes exclusion of the graft from the arterial circulation to the hand and removal of all existing thrombus.

Adult↗
PubMed1989

Ultralong, reverse-curve angiographic catheter.

An ultralong, reverse-curve angiographic catheter has been developed to facilitate selective internal pudendal arteriography for evaluation of vasculogenic impotence. The catheter has enabled successful selective catheterization of the internal pudendal arteries in 95% of more than 200 attempts. The catheters have also been used in approximately 100 vascular procedures other than pudendal arteriography.

Angiography↗
PubMed1989

Pulsed-spray pharmacomechanical thrombolysis: preliminary clinical results.

Pulsed-spray pharmacomechanical thrombolysis was used to treat 41 patients with 47 complete thrombotic occlusions of hemodialysis grafts (n = 29), arterial bypass grafts (n = 10), or peripheral native arteries (n = 8). The procedure involves the use of small pulses of highly concentrated urokinase, which are forcefully sprayed throughout the thrombus during systemic heparinization. Virtually complete lysis was achieved in 46 of 47 occlusions. In the 46 thrombi that lysed, mean time for completion of lysis was 63 +/- 35 min and initial partial return of flow required 26 +/- 18 min. Complications included small peripheral emboli in one treated bypass graft (which cleared promptly after further pulse-spray therapy) and bleeding in three cases (one case of hematoma in the infused field at the site of recent surgery, one case of bilateral hematomas at the femoral puncture site, and one minor delayed self-limited gastrointestinal hemorrhage). Results to date suggest that the pulsed-spray pharmacomechanical method augments the speed, consistency, safety, and cost efficacy of clinical thrombolysis. Further study is warranted.

Arteriovenous Shunt, Surgical↗
PubMed1988

Pharmacoangiographic assessment of the corpora cavernosa.

The present section presents further observations regarding cavernosometry and cavernosography, emphasizing the value of intracavernosal injection of a papaverine-phentolamine combination. Subsequent pharmacocavernosometry during fluid infusion then enables (1) precise quantitation of cavernosal leak by the pharmacologic maintenance erection flow (PMEF) method, and (2) determination of cavernosal pressure pulsations, a useful reflection of arterial sufficiency. In patients with excessive cavernosal leak, pharmacocavernosography supplements the examination by indicating the routes of persistent major venous drainage, key information in planning venoablative therapy. Compared with nonpharmacologic methods for cavernosometry and cavernosography, we feel the pharmacologic technique offers the following advantages: (1) it enables the highly accurate and reproducible PMEF method for quantitating cavernosal leakage; (2) the sites of abnormal leakage can be evaluated by cavernosography only after the pharmacologic technique; (3) the infusion volumes required to produce erection are smaller, more physiologic, and more conveniently administered; (4) the amplitude of the cavernosal pressure pulsation becomes useful as an index of arterial sufficiency; and (5) pulsations of the dorsal penile artery are amplified to the point of easy palpability, or more reliable Doppler detection.

Angiography↗
PubMed1988

Thyroid carcinoma masquerading as a solitary benign hyperfunctioning nodule.

Focal hot nodules on iodine thyroid images are associated with an exceedingly low incidence of malignancy. Most previously reported hot carcinomas represent the coexistence of small malignancies in or adjacent to a benign hot lesion. Described here is a 3-cm papillary carcinoma that fulfilled the criteria for benignancy on Tc-99m and I-123 imaging. Coincidental carcinoma within a benign lesion was excluded by detailed scintigraphic-pathologic correlation of the tumor. The implications of this case on the management of the solitary hot nodule are discussed and the literature reviewed.

Aged↗